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Penicillin-resistant pneumococci

B A Cunha1

  • 1Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.

Drugs of Today (Barcelona, Spain : 1998)
|April 20, 2004
PubMed

Insights

Penicillin resistance in Streptococcus pneumoniae is typically relative, not absolute. Preferring antibiotics like doxycycline or levofloxacin can help minimize the emergence of highly resistant strains.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Penicillin-resistant Streptococcus pneumoniae (PRSP) poses a significant threat to treating respiratory tract infections.
  • Current penicillin resistance in S. pneumoniae is predominantly relative, characterized by increased Minimum Inhibitory Concentrations (MICs).
  • These isolates often remain susceptible to standard or high antibiotic doses.

Purpose of the Study:

  • To explore strategies for minimizing the emergence of highly resistant Streptococcus pneumoniae strains.
  • To identify antibiotics with high antipneumococcal activity and low resistance potential.
  • To advise on the judicious use of vancomycin to prevent resistance.

Main Methods:

  • Literature review and analysis of antibiotic resistance patterns.
  • Evaluation of antibiotic activity against Streptococcus pneumoniae.
  • Assessment of resistance potential for various antibiotic classes.

Main Results:

  • Most penicillin resistance in S. pneumoniae is relative, allowing susceptibility to certain antibiotics at adequate doses.
  • Antibiotics such as doxycycline, cefprozil, levofloxacin, cefepime, and meropenem exhibit high antipneumococcal activity and low resistance potential.
  • Decreasing vancomycin use is crucial to mitigate the rise of vancomycin-resistant Enterococci (VRE) and vancomycin-intermediate Staphylococcus aureus.

Conclusions:

  • Preferential use of antibiotics with favorable resistance profiles can curb the development of highly resistant pneumococci.
  • Judicious antibiotic selection is key to effective treatment of respiratory infections and antimicrobial stewardship.
  • Careful monitoring and reduced reliance on vancomycin are necessary to preserve its efficacy and prevent broader resistance issues.

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